Texas Health and Human Services Digest: October 30, 2020

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From HHSC: While every effort has been made to offer an accurate and current listing of meeting agendas and events on this calendar, the information has been compiled from a variety of sources and is subject to change without notice to the user.

October 30, 2020

November 2, 2020

November 3, 2020

November 4, 2020

November 5, 2020

November 6, 2020

November 10, 2020

November 12, 2020

November 13, 2020

November 13, 2020

November 16, 2020

November 17, 2020

November 18, 2020

November 19, 2020

Proposed Rules
Formal Comments via the Texas Register
To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State. Interested parties then can review and comment on the proposed rule. The Secretary of State publishes a new issue of the Texas Register each Friday.

The Administrative Procedure Act (Texas Government Code, Chapter 2001) requires the notice published in the Texas Register to include a brief explanation of the proposed rule and a request for comments from any interested person. The notice also includes instructions for submitting comments regarding the rule to the agency, including the date by which comments must be submitted. Agencies must give interested persons “a reasonable opportunity” to submit comments. The public comment period begins on the day after the notice of a proposed rule is published in the Texas Register and lasts for a minimum of 30 calendar days.

Below is a list of proposed rules that have been published in the Texas Register. The proposed rules that are published in the Texas Register are open for public comment until the end of the comment period.

TitleProject No., DescriptionContactComment End Date
Repeal of Title 25, Chapter 415, Subchapter C, Use and Maintenance of Department of State Health Services/Department of Aging and Disability Services Drug Formulary#19R052: HHSC Psychiatric Drug FormularyHHS Health and Specialty Care11/23/20
Repeal of Title 40, Chapter 5, Subchapter C, Use and Maintenance of Drug Formulary#19R052: HHSC Psychiatric Drug FormularyHHS Health and Specialty Care11/23/20
New Title 26, Chapter 306, Subchapter G, Use and Maintenance of the Health and Human Services Commission Psychiatric Drug Formulary, Sections 306.351 – 306.360#19R052: HHSC Psychiatric Drug FormularyHHS Health and Specialty Care11/23/20
Title 1, Chapter 355, Subchapter B, Establishment and Adjustment of Reimbursement Rates for Medicaid, Section 355.205#21R015: Rate Increase Attestation Process COVID-19HHS Provider Finance Department11/23/20
Repeal of Title 1, Chapter 383, Interstate Compact on Mental Health and Mental Retardation#19R065: Interstate Compact CoordinationHHS Health and Specialty Care11/16/20
New Title 26, Chapter 903, Interstate Compact on Mental Health and Intellectual and Developmental Disabilities#19R065: Interstate Compact CoordinationHHS Health and Specialty Care11/16/20
Title 1, Chapter 354, Subchapter A, Division 1, Section 354.1003, Time Limits for Submitted Claims#20R006: Claims Payment Deadlines ExceptionsHHS Rules Coordination Office11/16/20
Title 25, Chapter 40, Subchapter D, concerning Maintenance and Administration of Asthma Medication#20R019: Asthma MedicationDSHS School Health Program11/16/20
Title 25, Chapter 40, Subchapters B and C, concerning Epinephrine Auto-Injector Policies in Certain Entities and Youth Facilities#20R018: Epinephrine Policies in Certain Entities and Youth FacilitiesDSHS School Health Program11/16/20

Draft Rules Informal Comments

Informal opportunities to comment occur before a rule is published in the Texas Register. HHS staff may solicit informal public and stakeholder input by:

  • inviting stakeholders to submit comments on potential rule changes during rule development.
  • sharing a draft rule with stakeholders for review.
  • using existing HHS advisory committees to comment on rules.

The following are draft rules on which HHS is accepting informal public or stakeholder input. All rules are posted in MS Word format unless otherwise noted.

TitleProject No.ContactComment Start DateComment End Date
Title 1, Chapter 354, Subchapter F, Division 8, Drug Utilization Review Board#21R007John Pepin10/30/2011/13/20
Title 26, Chapter 561, Employee Misconduct Registry (EMR)#19R045HHS Policy, Rules and Training10/30/2011/13/20
Title 26, Chapter 749, Minimum Standards for Child-Placing Agencies, concerning Legislative changes#20R101HHS Child Care Regulation10/19/2011/2/20

Now Available: New and Updated Documents Posted to the Direct Contracting Website for the Professional and Global Options.

Dear CMS Stakeholder,  
The Center for Medicare and Medicaid Innovation (Innovation Center) is excited to announce that new and updated publications are available on the Direct Contracting website.  These publications include:

  • An announcement listing the 53 Direct Contracting Entities (DCEs) participating in the Implementation Period.
  • An update to the published DC/KCC Rate Book to include the preliminary Aged and Disabled (AD) Concurrent County Rates in the DC/KCC Rate Book.  Please note that this version is still preliminary and the DC/KCC Rate Book may be updated before the start of the 2021 performance year.
  • An updated version of Frequently Asked Questions (FAQs), including a new Financial FAQ document relating to the financial specification papers that can be found under the Financial Methodology section.
  • A revised version of the ‘DC/KCC Risk Adjustment’ paper, including a numerical example on the application of normalization, the symmetric 3% cap, and the Coding Intensity Factor (CIF) in the appendix and a clarification to Table 4 and Table 11. This revised version also includes the preliminary normalization factor for High Needs DCEs in PY1 using the CMMI-HCC Concurrent risk model.

We encourage you to monitor the Direct Contracting website (https://innovation.cms.gov/innovation-models/direct-contracting-model-options) for future updates. Please contact our help desk with any questions/comments – DPC@cms.hhs.gov.

2021 Federal Health Insurance Exchange Open Enrollment Period Starts Sunday, November 1 on HealthCare.gov. The Centers for Medicare & Medicaid Services (CMS) is announcing that the Open Enrollment Period for the Federal Health Insurance Exchange will officially begin at HealthCare.gov on Sunday, November 1 and will run through Tuesday, December 15. Consumers will be able to log in to HealthCare.gov and CuidadodeSalud.gov or call 1-800-318-2596 to fill out an application and enroll in a 2021 Exchange health plan for coverage starting as soon as January 1, 2021.

Recently, CMS released a report showing the third consecutive year of improving market conditions, including lower premiums and more plan options, under the Trump Administration’s new policies. Three years of declining average second lowest cost silver plan (benchmark plan) premiums have combined to deliver an 8% average premium reduction across states using HealthCare.gov since the 2018 coverage year. Many consumers coming to HealthCare.gov will also find they have more options, given that issuer participation has also increased for the third year in a row. The percentage of HealthCare.gov enrollees with access to only one issuer is decreasing from 29% in 2018 to 4% in 2021 and more than three quarters of HealthCare.gov enrollees will have access to at least three issuers in 2021.

Current enrollees who don’t update their application and enroll in a plan by the deadline on December 15, 2020 will generally be automatically enrolled in the same plan, or another plan with the same insurance company intended to be as similar as possible. If that’s not available, they will generally be enrolled in another plan with a different insurance company. Consumers who miss the deadline to re-enroll in a plan of their choice during Open Enrollment will also not be able to make any plan changes until the next coverage year, unless they qualify for certain Special Enrollment Periods.

The Trump Administration’s goal has always been to ensure that all Americans have access to affordable, quality health coverage. Combined with improvements to the market, the updates to HealthCare.gov will provide a better consumer experience with more choices. To maximize enrollment opportunities for consumers in the Alaska and Hawaii time zones, individuals will have an additional two hours beyond the 11:59pm PT December 15th deadline to enroll in coverage. CMS encourages new and returning consumers to take this opportunity starting Sunday, November 1 to update their information, review their options and decide on coverage that best meets their needs for 2021 by the December 15 deadline for Exchange health coverage.

To view the 2021 Fact Sheet for more information, visit: https://www.cms.gov/newsroom/fact-sheets/federal-health-insurance-exchange-2021-open-enrollment

SNF QRP October Refresh 2020. The October 2020 refresh of SNF QRP data is now available on Nursing Home Compare (NHC), as well as the Nursing homes including rehab services web pages within Care Compare (CCXP) and Provider Data Catalog (PDC).

The data are based on quality assessment data submitted by SNFs to CMS from Quarter 1 2019 through Quarter 4 2019 (01/01/2019 –12/31/2019); and the annual update of the claims-based measures data from Quarter 4 2017 – Quarter 3 2019 (10/01/2017 – 9/30/2019).

Starting in October 2020, six additional SNF QRP measures will be publicly reported on NHC, CCXP and PDC:

  • Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury,
  • Drug Regimen Review Conducted with Follow-Up for Identified Issues – PAC SNF QRP,
  • Application of IRF Functional Outcome Measure: Change in Self-Care (NQF #2633),
  • Application of IRF Functional Outcome Measure: Change in Mobility (NQF #2634),
  • Application of IRF Functional Outcome Measure: Discharge Self-Care Score (NQF #2635), and
  • Application of IRF Functional Outcome Measure: Discharge Mobility Score (NQF #2636).

Please visit the Nursing Home Compare, as well as the Nursing homes including rehab services web pages within Care Compare (CCXP) and Provider Data Catalog (PDC) websites, to view the updated quality data.

Please note that the October 2020 refresh of the SNF QRP data on Nursing Home Compare/Care Compare Sites is the last scheduled refresh of this data until the January 2022 refresh. For additional information, please review the available SNF QRP Public Reporting Tip Sheet.

For questions about SNF QRP Public Reporting please email SNFQRPPRQuestions@cms.hhs.gov.

KidneyX Artificial Kidney Prize Offers $10 Million to Accelerate Artificial Kidney Development. The U.S. Department of Health and Human Services (HHS) and the American Society of Nephrology (ASN) launched the KidneyX Artificial Kidney Prize to accelerate the development of artificial kidneys toward human clinical trials. This multiphase competition is KidneyX’s first fully dedicated effort toward artificial kidney advancement, with initial phases offering up to $10 million in prizes. Phase 1 seeks solutions that enable and advance the functionality, effectiveness, and/or reliability of artificial kidneys.

The goal of the Artificial Kidney Prize is to accelerate the development of continuous kidney replacement therapies that provide transformational treatment options beyond current dialysis methods, as outlined in the Technology Roadmap for Innovative Approaches To Renal Replacement Therapy. Entrants are encouraged to address one or more priority topic areas  ; however, the competition remains open to solutions that advance artificial kidneys in other ways.

Innovation in kidney care is urgently needed: More than 850 million people worldwide live with kidney diseases, including 37 million Americans. Current treatment methods have not changed significantly in more than 60 years and cost more than $100 billion per year in the U.S. alone – PDFThirteen people die each day waiting for a kidney transplant, and those on dialysis face a 40% mortality rate within the first three years of treatment  , which is a worse outcome than most cancers.

The Artificial Kidney Prize is open to both U.S. and international entrants, subject to eligibility requirements. Phase 1 calls for component or integrated prototype solutions with demonstrated performance, including proof of concept data, and detailed development plans. Phase 1 submissions are due by 4:59 p.m. ET on March 24, 2021. The judging panel will recommend up to eight winners, and up to $4 million in Phase 1 prizes will be distributed at the discretion of HHS and ASN.

To learn more about participating, entrants can join a virtual information session on December 3.

Phase 2 of the Artificial Kidney Prize will be open to eligible entrants from Phase 1, as well as new eligible entrants who did not enter the first phase. The second phase of the competition will focus on initial integration of prototype solutions into an artificial kidney, or advancement of already integrated prototype solutions. Phase 2 will award up to $6 million in prizes and is expected to launch in October 2021.

Learn more about the Artificial Kidney Prize at akp.kidneyx.org.

Read the full release.

The following new report has been posted on the Reports and Presentations page:

October 2020

To see a list of all reports and presentations go to the Reports and Presentations page.

Informal Comments on Draft Rules Due 11/13 on Drug Utilization Review Board and Employee Misconduct Registry. Texas Health and Human Services Commission is accepting informal comments from stakeholders on the following draft rules. The comment period ends November 13, 2020.

  • Texas Health and Human Services Commission Title 1, Part 15, Chapter 354, Subchapter F, Division 8, Drug Utilization Review Board. Comments can be emailed to John Pepin.
  • Texas Health and Human Services Commission Title 26, Part 1, Chapter 561, Employee Misconduct Registry (EMR). Comments can be emailed to HHS Policy, Rules and Training.

Questions can be emailed to HHS Rules Coordination Office.

Visit the HHS Rulemaking website for more information.

Changes to Texas Administrative Code Chapter References for HHS System. As part of the transformation of the Health and Human Services (HHS) system, rule chapters are being relocated in the Texas Administrative Code (TAC).

Effective November 15, 2020, rules in:

  • 40 TAC Social Services Assistance, Part 1, Department of Aging and Disability Services, Chapter 85, Implementation of the Older Americans Act

Will be transferred to:

  • 26 TAC Health and Human Services, Part 1, Texas Health and Human Services Commission, Chapter 213, Area Agencies on Aging, Subchapter C,  Implementation of the Older Americans Act.

The table below outlines recent rule transfers.

Rule TitleCurrent TACNew TAC
Definitions40 TAC 85, Sub A26 TAC 213, Sub C, Div 1
AAA Administrative Requirements40 TAC 85, Sub C26 TAC 213,  Sub C, Div 2
Older Americans Act Services40 TAC 85, Sub D26 TAC 213, Sub C, Div 3
Management and Oversight40 TAC 85, Sub F26 TAC 213, Sub C, Div 4

You will need to refer to the new TAC chapters after November 15. All letters, memoranda, and other guidance remain in effect while HHSC updates outdated references. The rule transfer notice was posted in the October 30, 2020, issue of the Texas Register.

If you have questions about these administrative moves, email the Rules Coordination Office.

DFPS Email Addresses Are Changing. The Department of Family and Protective Services (DFPS) will be changing email addresses over several months beginning in November. All DFPS email addresses ending in @dfps.state.tx.us will change to addresses ending in @dfps.texas.gov. This will make DFPS email addresses easier to remember and align them with those of many other Texas state agencies.

There is nothing you need to do right now. Emails to or from DFPS will not be disrupted during this transition. New emails sent to old DFPS email addresses will forward to the corresponding new email addresses until the end of 2022. Whether you send a new email to an old or new DFPS email address, your email will be delivered.

However, if you reply to an email containing the old email address of a DFPS employee after his or her email address has changed, you may receive a message that the email was not delivered. In that case, you would need to change the email suffix to @dfps.texas.gov and resend it. If you know the person’s email has changed, you can change the address before you reply.

DFPS employees who regularly do business with you should let you know when their individual email addresses have changed. We encourage you to update their contact information in your address book at that time to avoid any disruption after December 2022, when email forwarding ends.

You will always find the latest information on this transition in the Email Address Change FAQ on the DFPS website.

Healthy Outcomes through Prevention and Early Support (HOPES) Request for Applications Released

Request for Applications: The Prevention and Early Intervention (PEI) Division seeks Applications from qualified entities within the State of Texas to provide Healthy Outcomes through Prevention and Early Support (HOPES) Program services. HOPES Grantees partner with Families with children zero (0) to five (5) years of age to offer parent education, service coordination, parent advocacy, and basic needs support. This Request for Applications (RFA) will sustain the established service areas and expand to other Texas counties where there is high risk for child maltreatment rates. The continuation of child maltreatment prevention programming in counties already implementing HOPES will ensure a positive impact on county-level child maltreatment rates across Texas.

The RFA can be found at the following link.

Due Date: Applications are due January 29, 2020 at 10:30 A.M. Central Time.

Applicant Webinar
PEI encourages potential applicants to attend the optional pre-submittal applicant webinar on November 12, 2020 at 11:00 A.M. Central Time.

Applicants may register for this optional webinar here:
Pre-Submittal Webinar

All requests, questions or other communication about this RFA shall be made in writing to the Sole Point of Contact addressed to the person listed below. All communications between Applicants and DFPS staff members concerning the RFA are strictly prohibited, unless noted elsewhere in this RFA. Failure to comply with these requirements may result in disqualification of Applicant’s Grant Application.

Jennifer Kim, CTCD, CTCM
Health and Human Services Commission
1100 West 49th Street; Mail Code 2020
Building S
Austin, TX 78756